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Periodically I read decisions as they come out of the Courts regarding medical inadmissibility. This case (De Hoedt Daniel) was heard here in Vancouver – I wish I’d been there to hear the arguments. While the finding of excessive demand medical inadmissibility was upheld, the judge had some unusual words to say. For anyone dealing with issues of medical inadmissibility there are valuable lessons in this case: be prepared, present a credible plan. The shape of a possible plan just isn’t enough. Indeed, this is the same lesson as Companioni – your plan must be real enough to convince a CIC officer.

Of course, even so, such a plan is not a guarantee of success. They turned down my plan – even though it was a real, in place plan. The final rationale offered for rejecting my plan (“we weren’t convinced that the plan would work for medication available for free from the province”) was created after-the-fact and failed on even a cursory analysis – the plan included a non-discretionary plan. I also verified that the insurance would cover the medications by actually filling prescriptions – although that was done after the rejection. Had the visa office expressed that concern, it would have been easily addressed. They didn’t do so however – they just rejected.

Here is the interesting comment at the end of the decision (an obiter dictum):

It is recommended by the undersigned that the number of well-intentioned individuals, organizations and entities, having come forward to assist the Applicant with the care of the said child, begin the process again and that the Canadian authorities give priority to that process, recognizing the time and effort that has already been given to the voluminous documents accompanying the application for permanent residence by all involved, including the specific individuals and entities in Maple Ridge, British Columbia.
It would seem that a viable plan requires the preparation of a practical commitment on paper to ensure that it is acknowledged and understood as such by the authorities who would then make their decision thereon.

This is an essential point for anyone involved in a fairness response: your plan needs to be real, it needs to be concrete and it needs to be clear to the decision maker that it overcomes the initial concern of excessive demand.

I cannot stress this enough: you must have a credible plan. It needs to be in-place, workable and it must address the cost concerns – remember, this is all about money. That’s the issue you must address.

Ideally, anyone in this situation (dealing with a fairness letter regarding medical inadmissibility) should keep this point in mind: have a clear plan. Make it concrete and real. If it is hypothetical or the visa officer has any doubts about the viability of the plan, it will likely be rejected. Better to do the up-front work and overcome the objection before it makes it before the court.